The Psychology of Hearing Loss

If we seriously want to understand hearing loss, we have to understand both the physical side, which makes hearing progressively more difficult, and the psychological side, which includes the lesser-known emotional reactions to the loss of hearing. Jointly, the two sides of hearing loss can wreak havoc on a person’s total well being, as the physical reality creates the loss and the psychological reality prevents people from dealing with it.

The numbers tell the story. While almost all instances of hearing loss are physically treatable, only around 20% of individuals who would benefit from hearing aids make use of them. And even among people who do seek help, it takes an average of 5 to 7 years before they book a hearing test.

How can we explain the immense discrepancy between the possibility for better hearing and the commonplace hesitancy to obtain it? The first step is to acknowledge that hearing loss is in fact a “loss,” in the sense that something invaluable has been taken away and is apparently lost forever. The second step is to figure out how people typically respond to losing something invaluable, which, courtesy of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand extremely well.

Elizabeth Kübler-Ross’ 5 stages of grief

Kübler-Ross detected 5 stages of grief that everyone coping with loss appears to pass through (in incredibly consistent ways), although not everyone does so in the same order or in the same time period.

Here are the stages:

Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferable reality.

Anger – the individual recognizes the loss but becomes angry that it has happened to them.

Bargaining – the individual reacts to the feeling of helplessness by seeking to take back control through bargaining.

Depression – comprehending the weight of the loss, the individual becomes saddened at the hopelessness of the situation.

Acceptance – in the final stage, the individual accepts the circumstance and exhibits a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the restoring of control over emotions and behavior.

People with hearing loss progress through the stages at different rates, with some never getting to the last stage of acceptance — hence the gap between the possibility for better hearing and the low numbers of people who actually seek help, or that otherwise wait a number of years before doing so.

Progressing through the stages of hearing loss

The first stage of grief is the most difficult to escape for those with hearing loss. Seeing that hearing loss advances gradually through the years, it can be very difficult to detect. People also tend to make up for hearing loss by turning up the TV volume, for instance, or by forcing people to repeat themselves. Those with hearing loss can remain in the denial stage for many years, saying things like “I can hear just fine” or “I hear what I want to.”

The next stage, the anger stage, can manifest itself as a form of projection. You may hear those with hearing loss state that everybody else mumbles, as if the issue is with everyone else rather than with them. People persist in the anger stage until they realize that the problem is in fact with them, and not with others, at which point they may advance on to the bargaining stage.

Bargaining is a form of intellectualization that can take different forms. For instance, people with hearing loss might compare their condition to others by thinking, “My hearing has become a lot worse, but at least my health is good. I really shouldn’t complain, other people my age are coping with genuine problems.” You might also come across those with hearing loss devaluing their problem by thinking, “So I can’t hear as well as I used to. It’s just part of growing old, no big deal.”

After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may go into a stage of depression — under the mistaken assumption that there is no hope for treatment. They may persist in the depression stage for a while until they realize that hearing loss can be treated, at which point they can enter the last stage: the acceptance stage.

The acceptance stage for hearing loss is surprisingly elusive. If only 20% of those who can benefit from hearing aids actually wear them, that means 80% of those with hearing loss never get to the final stage of acceptance (or they’ve arived at the acceptance stage but for other reasons choose not to act). In the acceptance stage, people acknowledge their hearing loss but take action to correct it, to the best of their ability.

This is the one positive side to hearing loss: in contrast to other forms of loss, hearing loss is partially recoverable, making the acceptance stage much easier to reach. Thanks to major advances in digital hearing aid technology, people can in fact improve their hearing enough to communicate and engage normally in daily activities — without the stress and difficulty of impaired hearing — enabling them to reconnect to the people and activities that give their life the most value.

Which stage are you in?

In the case of hearing loss, following the crowd is going to get you into some trouble. While 80% of those with hearing loss are trapped somewhere along the first four stages of grief — struggling to hear, damaging relationships, and making excuses — the other 20% have accepted their hearing loss, taken action to strengthen it, and rediscovered the joys of sound.